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NPI Code Detail

MEDICARE: KRISTIN GOODWIN LPC

MEDICARE:   KRISTIN  GOODWIN  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor66602TX

General Provider Information

NPI Number : 1285036939
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN GOODWIN LPC
Provider Business Mailing Address
First Line : 3976 CREEKSIDE LN
Second Line :
City : CARROLLTON
State : TX
Zip : 75010-6479
Country : US
Telephone Number : 972-754-8086
Fax Number :
Provider Business Practice Location Address
First Line : 8105 RASOR BLVD # 259
Second Line :
City : PLANO
State : TX
Zip : 75024-0116
Country : US
Telephone Number : 972-754-8086
Fax Number : 972-526-7903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2014
Last Update Date : 04/05/2017

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Directions to “ KRISTIN GOODWIN LPC” Practice Location

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